单纯玻璃体腔注气治疗高度近视黄斑裂孔视网膜脱离的临床疗效:北京同仁眼科中心的结果  

Efficacy of intravitreal gas injection for retinal detachment resulting from macular hole in myopic eyes

作　　者：周丹[1] 魏文斌[1] 段欣荣[1] 杨承勋[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,100730

出　　处：《眼科》2011年第1期64-68,共5页Ophthalmology in China

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2009-3-32);北京市自然科学基金(7092021;7072019);首都特色临床医学技术发展研究(Z080507030808)

摘　　要：目的探讨单纯玻璃体腔注气治疗高度近视合并黄斑裂孔视网膜脱离的疗效。设计前瞻性随机对照研究。研究对象北京同仁医院24例(24眼)屈光度超过–6.0D黄斑裂孔视网膜脱离患者。方法随机分为单纯C3F8注气组(A组)14例、玻璃体切割联合C3F8注气组(B组)10例。手术前后检查矫正视力、眼压、裂隙灯显微镜、眼底、眼部超声波和相干光断层扫描(OCT)。术后平均随诊(27.3±12.8)个月。主要指标视网膜复位例数,术后视力,手术费用。结果术后最后随诊时,单纯C3F8注气组、玻璃体切割联合C3F8注气组间手术复位率分别为28.6%(4/14例)和20%(2/10例),视力改善≥2行例数亦分别为4例和2例(P均=1.00)。两组间手术费用比较有显著性差异(P=0.000)。结论单纯玻璃体腔C3F8注气治疗高度近视合并黄斑裂孔视网膜脱离是一种可供选择的经济、有效的手术方式。Objective To evaluate the efficacy of intravitreal gas injection in treating retinal detachment due to macular hole in high myopia,compared with pars plana vitrectomy（PPV） with intraocular gas tamponade.Design Prospective,randomized controlled case series.Participants 24 eyes of 24 patients with retinal detachment owing to myopic macular hole in Beijing TonRen Hospital.Methods All patients were randomly assigned to undergo intravitreal perfluoropropane（C3F8） gas injection（group A） or vitrectomy with intraocular C3F8 gas tamponade（group B）.Complete ocular examination included best-corrected visual acuity,intraocular pressure,slit-lamp biomicroscopy,color fundus photography,ultrasound examination,and optical coherence tomography at baseline and every 3 months after the surgery.The follow-up time was 27.3±12.8 months after operation.Main Outcome Measures Retinal reattachmentrates,the postoperative best-corrected visual acuity and the costs during the treatment.Results At the last follow-up after surgery,the retinal reattachment rates in group A was 28.6%（4 cases） and 20%（2 cases）（P=1.00） and the visual improvement（≥2 lines） rate in group A was 28.6%（4 cases） and 20%（2 cases）（P=1.00）.But the costs between two groups was significantly different（P=0.000）.Conclusion Intravitreal C3F8 gas injection alone was a safe,effective and low cost way in treating retinal detachment owing to macular hole in high myopia.

关 键 词：玻璃体切除 注气 黄斑裂孔 视网膜脱离 

分 类 号：R779.6[医药卫生—眼科]